Video-assisted thoracoscopic decortication versus open decortication for a better surgery results. | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 43, Issue 4, October 2024, Page 1463-1470 PDF (515.09 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/EJSUR.2024.293633.1090 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Ahmed R.M.R. Elbasiouny* ; Ahmed A. ElNory; Ahmed M. Mostafa; Mostafa A. ElDewer | ||||
| Department of Cardiothoracic Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Comparing video-assisted thoracoscopic decortication with open decortication: advantages and disadvantages. Aim: In this study, we aim to compare the outcomes associated with VTASD and OD in terms of less surgical trauma and improving postoperative pain. Patients and Methods: We did a prospective comparative study involving 60 patients with thoracic empyema. Patients were randomly allocated to undergo Video-assisted thoracoscopic surgery (VATS) decortication or open decortication. The patients were split up into two groups, each with 30 patients: open thoracotomy (OT) and VATS. We contrasted the frequency of postoperative pain, adjusted length of hospital stay, air leak, incomplete lung inflation, blood transfusion, wound infection, reoperation, and death following surgery. Results: Postoperative pain score using the visual analogue scale was compared in the two groups. Regarding postoperative pain, the median for VATS was 3 with an interquartile range (IQR) of 2–4, and for OT the median was 8 with an IQR of 7–8 with a highly significant statistical difference. This can be the result of the intercostal neuralgia that occurs due to injury to the intercostal nerves when access is gained to the thoracic cavity by spreading the ribs and dissecting the pleura. Owing to the procedure’s short incision, lack of rib spreading required, and minimum intraoperative manipulation, it has been suggested and confirmed in the literature thus far that patients having VATS had less postoperative discomfort and a lower need for analgesics. In reference to the hospital stay, our analysis showed that the OT group median was 7–9 with an IQR of 7–9 and a high statistically significant. Whereas the VATS group median was 5 with an IQR of 5–6. Conclusion: Video assisted thoracoscopic decortication is a safe procedure, and provides less postoperative complications, less postoperative pain, and less hospital stay which leads to better surgery results. | ||||
| Keywords | ||||
| Decortication; empyema; open; video-assisted thoracoscopic surgery | ||||
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